9 April 2018
Key facts
Schizophrenia is a chronic and severe mental disorder affecting more than 21 million people
worldwide.
Schizophrenia is characterized by distortions in thinking, perception, emotions, language,
sense of self and behaviour. Common experiences include hallucinations - hearing voices or
seeing things that are not there and delusions – fixed, false beliefs.
Worldwide, schizophrenia is associated with considerable disability and may affect
educational and occupational performance.
People with schizophrenia are 2-3 times more likely to die early than the general population.
This is often due to preventable physical diseases, such as cardiovascular disease,
metabolic disease and infections.
Stigma, discrimination and violation of human rights of people with schizophrenia is
common.
Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective.
Facilitation of assisted living, supported housing and supported employment are effective
management strategies for people with schizophrenia.
Symptoms
Schizophrenia is a psychosis, a type of mental illness characterized by distortions in thinking,
perception, emotions, language, sense of self and behaviour. Common experiences include:
Hallucination: hearing, seeing or feeling things that are not there.
Delusion: fixed false beliefs or suspicions not shared by others in the person’s culture and that are
firmly held even when there is evidence to the contrary.
Abnormal Behaviour: disorganised behavior such as wandering aimlessly, mumbling or laughing to
self, strange appearance, self-neglect or appearing unkempt
Disorganised speech; incoherent or irrelevant speech
Disturbances of emotions: marked apathy or disconnect between reported emotion and what is
observed such as facial expression or body language
Schizophrenia is associated with considerable disability and may affect educational and occupational
performance.
People with schizophrenia are 2-3 times more likely to die early than the general population. This is
often due to physical illnesses, such as cardiovascular, metabolic and infectious diseases.
Stigma, discrimination and violation of human rights of people with schizophrenia is common.
Causes of schizophrenia
Research has not identified one single factor. It is thought that an interaction between genes and a
range of environmental factors may cause schizophrenia.
Services
More than 50% of people with schizophrenia are not receiving appropriate care. Ninety per cent of
people with untreated schizophrenia live in low- and middle- income countries. Lack of access to
mental health services is an important issue. Furthermore, people with schizophrenia are less likely to
seek care than the general population.
Management
Schizophrenia is treatable. Treatment with medicines and psychosocial support is effective. However,
the majority of people with chronic schizophrenia lack access to treatment.
There is clear evidence that old-style mental hospitals are not effective in providing the treatment that
people with mental disorders need and violate basic human rights of persons with mental disorders.
Efforts to transfer care from mental health institutions to the community need to be expanded and
accelerated. The engagement of family members and the wider community in providing support is very
important.
Programmes in several low- and middle- income countries (e.g. Ethiopia, Guinea-Bissau, India, Iran,
Pakistan, Tanzania) have demonstrated the feasibility of providing care to people with severe mental
illness through the primary health-care system by:
WHO response
WHO's Mental Health Gap Action Programme (mhGAP), launched in 2008, uses evidence-based
technical guidance, tools and training packages to expand service in countries, especially in resource-
poor settings. It focuses on a prioritized set of conditions, directing capacity building towards non-
specialized health-care providers in an integrated approach that promotes mental health at all levels of
care. Currently mhGAP is implemented in more than 100 Member States.
The WHO QualityRights Project involves improving the quality of care and human rights conditions in
mental health and social care facilities and to empower organizations to advocate for the health of
people with mental disorders.
WHO’s Mental Health Action Plan 2013-2020, endorsed by the World Health Assembly in 2013,
highlights the steps required to provide appropriate services for people with mental disorders including
schizophrenia. A key recommendation of the Action Plan is to shift services from institutions to the
community.
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